There is an extraordinarily high cardiovascular morbidity and mortality in patients with chronic renal failure. Insulin resistance, dyslipidemia and hypertension form a cluster of risk factors present in these patients. There may be a link between these risk factors which predisposes patients with renal failure accelerated cardiovascular disease. The goal of this proposal is to test whether dysregulation of insulinmediated suppression of non-esterified fatty acids is associated with enhanced alpha l adrenergic receptor vascular reactivity in patients with moderate chronic renal failure. The research proposed is critical in defining lipid abnormalities in renal failure which may be associated with hypertension in this population. This research may provide further support for a potential link between the cardiovascular risk factor, dyslipidemia, insulin resistance and hypertension, which will lead to further research focusing on vascular pathophysiology associated with accelerated cardiovascular disease.